Posted on 05/05/2007 8:48:12 AM PDT by shrinkermd
THE RELEASE ...Of all the entitlement programs, Medicare is on the most dangerously unsustainable financial course, squeezed simultaneously by rising health-care costs and an aging population.
When Congress passed the Medicare prescription drug bill four years ago, it included a mechanism designed to call attention to runaway spending in the health care program for seniors and the disabled. Medicare is funded by a combination of payroll taxes (hospital costs) and general revenue (doctor's visits and prescription drug costs). ... That alarm sounded for the first time last year and was repeated again last week. The second warning requires that the president -- in the budget he will submit early next year -- propose changes to reduce Medicare's drain on the Treasury. Under the law, Congress must quickly consider those remedies, though it doesn't have to act.
This is an especially blunt instrument to deal with an especially large problem, and the Bush administration's proposed solution, to require automatic cuts, is too crude. The challenge facing Medicare isn't how it's funded, it's how much it costs. Indeed, the program was designed to be financed in a hybrid fashion, and the very prescription drug bill that included the arbitrary 45 percent trigger tilted the mix more toward general revenue...
President Bush, to his credit, has proposed some ways of taming the Medicare monster. In this year's budget, he calls for $66 billion in Medicare cuts over the next five years. Of this, $10 billion would come from requiring higher-income beneficiaries -- $80,000 in annual income, $160,000 for a couple -- to pay higher premiums for prescription drug coverage,
(Excerpt) Read more at washingtonpost.com ...
Many doctors are refusing Medicare patients because of the horrible regulatory tangle in the program and the slow payments from the government. If enough doctors refuse Medicare patients, the problem will fix itself. Many of our elderly will have to find something else to do with their time than drive to the doctor three times a week to get new prescriptions so they can frolic again as the TV ads promise they will.
For years now, I have always thought that people should be given an option, during their working years. That option would include two things. Allow them to not only pay for their medical insurance, but to add some to help pay for their insurance after they retire. Insurance companies would make a fortune just on the interest on those additional payments which would pay for the insurance in later years.
The second thought would be to give people an option to contribute to a Medicare account that would help offset the cost when they become 65. If they did not want to contribute a set amount, minimal at best, then they would be have to pay the full amount, which should be higher than it is now. The interest on these accounts, figuring that the person would be working for 20-30 years, would be huge. Of course all this additional money would need to be placed in an organization other than the governments pockets and strictly controlled. Just an idea.
Yeah....why don’t we just let all our parents and grandparents die. You slap our elderly in the face by that remark as though they are using our system of trying to take care of them. As in any business, doctors know that eventually it will all catch up and their payments will be coming in on a regular basis. Unless of course the doctor has questionable practices.
My mother-in-law visits the doctor about every other week. She demands all manner of diagnostic procedures, pain meds that she is sorely addicted to, and various imaginery complaints that often prove unfounded. She has been taken by ambulance in the middle of the night 3 times in the last year just to get pain medication — this occurred when she ran out of her morphine derivative. She says it is all free and it costs here little of nothing. This attitude and abuse of the system is busting the budget and I suspect it occurs nationwide. She is also on 7 or 8 other drugs and thinks there is a pill for every ailment.
It’s not the elderly that are doing this. It’s the doctors. My father, before he passed on, did the same thing. When I flew in from another state to see him, at my mothers request, I took him to his doctor and I had him bring all his medication. I was amazed at how much the doctors were giving him. A large plastic bag full of medications. If he had a pain, they would give him another pill. The elderly were raised to rely on their doctors. The doctors, today, take advantage of that. Even during my fathers failing, he taught me an important lesson.
I had a stroke a couple of years ago. The doctor put me on blood pressure and cholesterol meds. I told him of my father and that he wasn’t going to put me on 15 different pills. Doctors know that by taking one pill, they may have to put you on another pill to counter the effects of the first pill and it goes on and on. So it’s not the elderly, it’s the doctors that get paid by the pill companies.
My doctor recently put up a new sign that says “We no longer accept Medicare. Please pay in full for all services rendered and Medicare will reimbuse you.”
Take this with no disrespect. My father died in 96 and never a day goes by that I don’t think fondly of him. Dad went to doctors, maybe once a decade and never took any medications. He died with pneumonia at 85 but his mind was gone. To the best of my knowledge, Drs. don’t get paid by drug companies nor do they make money from medications, however, they do provide drugs for every complaint. It seems the planet was populated by 4 billion people before the so-called “healthcare crisis” ever came along in the mind of some sniveling politician. My Dad never had insurance because he self-insured by taking care of himself and when he went to the Doctor he paid cash. I actually think my mother-in-law enjoys going to the doctor — her health issues are all she talks about and every ailment from sneezing, to rashes, to GI upset is a crisis that requires immediate physician attendance.
I have several friends and a few relatives that are physicians — they are all good people and they work very long and arduous hours. I don’t see that Drs. are overpaid and in general most are very good people. If you want to see overpaid, look to entertainers, and shyster lawyers, not Drs.
Actually, not only is Medicare ridiculously slow, the reimbursement itself is terrible. In my specialty, anesthesiology, I lose money on every Medicare patient that I care for. Add to that the threat of an audit that makes a visit from the IRS seem like a treat. And don't believe that they won't fine you or even jail you if you are honest. Innocent mistakes such as case times overlapping by as little as one minute, due to non synchronous clocks, have resulted in hundreds of thousands in fines.
Believe it. This system is broken beyond repair.
Yeah...Well some of these “elders” are aging baby boomers and just above that age group whose attitudes towards health care need re-adjustment.
Much of what I’ve seen resembles a huge scam: both on the part of the medical establishment and those who use the system. The boldest and most insidious scamming goes on in the taxpayer funded - bureacrat run Medicare/ medicaid system.
I must have missed that one. Please tell me how I may be paid by a pill company other than by doing work for one.
Oh wait. you must be referring to all of those free vacations and cruises that the pharmaceuticals companies provide to doctors. Those abuses have been quite illegal for many years.
Neo - Like the post. Sadly you’re describing a time when personal responsibility was the rule of the day, unlike today.
Healthcare unfortunately has become a “right”. And thanks to stupid managed care, everyone thinks they can go to the Dr. anytime they like for a simple little $10 copay. If only they knew how the game was really played - but they don’t.
Wake up not feeling - call the Dr. and demand to be seen. It’s only a $10.00 copay
Get a fever in the night - off to the hospital emergency room. It’s only a $25.00 copay
Have a headache for a couple of days, off to the Dr. where he’ll order a head CT because he’s practicing defensive medicine. But don’t worry, it’s no big deal, it’s only a $10 copay!
And on and on it goes. Big trouble ahead. Wouldn’t want to be in my 20’s right now. They have no idea what’s coming.
Personally, Medicare & Medicaid should be consolidated into a single insurance program strictly for existing seniors (those born before 1950, IMO) and those with clear disabilities (kick the so-called "low-income" folks off of Medicaid), and it should be contracted out to private insurance companies, much like the Part D plan is now.
FR Line of the Day!
Yep, but the gutless politicians won’t end it. Instead, they’re gonna stick it to the younger generation in the manner of increased payroll taxes. Think 7.65% is high, wait til all the “baby boomers” hit Medicare and Social Security.
You just wait, you ain’t seen nothin yet.
I’m at the tail end of the baby boomer phase, and people keep flooding over our borders, most of which are never sent home, and many of which will have children they can’t (and even more appalling, won’t) support.
I'm asking this because I know nothng about Medicare.
When you say that they've reached the maximum care allowed by Medicare, is that because there is some kind of a monthly, yearly (or whatever) cap on what they'll pay for? If there is a cap, would a Medicare gap policy cover those additional expenses?
Yes! You don’t have to be the Amazing Kreskin to forsee it either.
But when it happens there will be herds of sheeple wandering around aimlessly going “huh?”, “huh?” “whahoppen?”.
In my view, there are really three major groups of people driving our current healthcare crisis.
1. Over utilization of services by the insured.
2. Unscrupulous providers - many haven’t been caught yet though I recently turned on in to the OIG.
3. Lawyers
It’s NOT the ethical providers that are causing the crisis.
Anecdotally, when I was growing up, I often had earaches, colds, etc. What was different then from today was there was no managed care. Parents took me to the doctor, paid him at the time of service, and when they had insurance, came home and filed the claim themselves - most of the time subject to a deductible. Thus, my parent’s didn’t run me off to the Dr. every-time I had an earache or cold.
They were a big part of controlling spending. Then came managed care in the 70's and the rest is history. Today’s generation knows nothing of this approach to healthcare and will run to the doctor at the drop of the hat. HSA’s will contribute to the self-regulation of healthcare, but it's only a VERY small part of spending today. Perhaps it will grow, but it will take a while to pry the insurance cards away from the addicted managed care patients.
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